8414.5-E-Alcohol and Drug Testing Program Acknowledgment Form

Alcohol and Drug Testing Program Acknowledgment Form

I, (NAME HERE) , have received, read and understand the Alcohol and Drug Testing Program policy and regulation. I consent to submit to the alcohol and drug testing program as required by law and district policy and regulation.

I understand that if I am being required to submit to a pre-employment alcohol test or a dilute specimen re-test, such test is required pursuant to district policy for employment with the district and not pursuant to federal regulations.

I understand that if I violate district policy, regulation or the law, I may be subject to discipline up to and including termination or I may be required to successfully participate in a substance abuse evaluation and, if recommended, a substance abuse treatment program. If I am required to and fail to or refuse to successfully participate in a substance abuse evaluation or recommended substance abuse treatment program, I understand I may be subject to discipline up to and including termination.

Reviewed December 13, 2005
Reviewed January 5, 2010
Reviewed June 16, 2015
Reviewed January 23, 2018

The district is not responsible for facts or opinions contained on any linked site. Some links and features on this site require the Adobe Acrobat Reader to view. Visit the Adobe website to download the free Acrobat Reader. This website was produced by the Capital Region BOCES Communications Service, Albany, NY. Copyright © 2018. All rights reserved.